床旁β-羟丁酸快速检测对糖尿病酮症及酮症酸中毒筛查及诊疗意义

Significance of rapid detection ofβ-hydroxybutyric acid in the diagnosis and treatment of diabetic ketosis and ketoacidosis

目的探讨床旁β-羟丁酸(β-HB)快速检测对糖尿病酮症(DK)及酮症酸中毒(DKA)筛查中的作用及检查效能。方法选取2019年1月~2019年12月收治的入院随机血糖>13.9 mmol/L的糖尿病患者162例,检测床旁β-HB,将酮症以及酮症酸中毒患者47例设为研究组,非酮症以及酮症酸中毒患者115例设为对照组。观察分析两组患者血酮与尿酮体、动脉血气pH值、HCO3-水平以及静脉血糖间的相关性;分析尿酮和末梢血β-HB在疾病诊断中的准确性及阳性率。结果经相关性显示,末梢血β-羟丁酸与尿酮体以及静脉血糖呈正相关(P<0.05),且与动脉血pH及HCO3^-呈负相关(P<0.05);末梢血β-羟丁酸诊断准确性及阳性率明显高于尿酮体诊断(P<0.05);研究组检测β-HB、FBG及HbA1c水平明显高于对照组(P<0.05)。结论应用床旁β-羟丁酸快速检测对糖尿病酮症及酮症酸中毒进行检查的准确率及阳性率较高,末梢血β-羟丁酸在糖尿病酮症和酮症酸中毒早期诊断及治疗中具有临床应用价值。

Objective To investigate the role and efficacy of near-bedsideβ-hydroxybutyric in the screening of diabetic ketosis(DK)and ketosis acidosis(DKA).Methods 162 diabetic patients with random blood glucose of>13.9mmol/L who were admitted to our hospital from January 2019 to December 2019 were selected.Besides,47 patients with ketosis and ketoacidosis were divided into the study group,while 115 patients with non-ketosis and ketoacidosis were divided into the control group.The correlation between blood ketone and urine ketone body,arterial blood gas pH value,HCO3-level and venous blood glucose in the two groups was observed and analyzed.And analyzed the accuracy and positive rate of the uroketone and the peripheral blood of hypo-hb in the diagnosis of diseases.Results The correlation showed that the peripheral blood ofβ-hydroxybutyric acid was positively correlated with the urinary ketone body and venous blood glucose(P<0.05),and negatively correlated with arterial blood pH and HCO3^-(P<0.05).The diagnostic accuracy and positive rate of tsa in peripheral blood were significantly higher than that in urine ketone body(P<0.05).Theβ-HB、FBG、HbA1c levels of the study group were significantly higher than that of the control group(P<0.05).Conclusion The detection accuracy and positive rate ofβ-hydroxybutyric acid(β-hydroxybutyric acid)in the early diagnosis and treatment of diabetic ketosis and ketoacidosis are higher with the rapid detection of beside the bed.Moreover,it is more scientific and effective in the early diagnosis and treatment ofβ-hydroxybutyric acid(β-hydroxybutyric acid)in the peripheral blood.Therefore,it can be popularized and applied.